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1.
Gastroenterol Hepatol ; 45(10): 805-818, 2022 Dec.
Article in English, Spanish | MEDLINE | ID: covidwho-2259091

ABSTRACT

Patients with inflammatory bowel disease (IBD) may require different immunosuppressive treatments throughout their illness. It is essential to assess the immunization status of patients at diagnosis or, if this is not possible, at least before the beginning of immunosuppressive therapy and, subsequently, administering the appropriate vaccines. Therefore, the aim of this work is to establish clear and concise recommendations on vaccination in patients with IBD in the different settings of our clinical practice including vaccination in children, during pregnancy, breastfeeding or on trips. This consensus document emphasises the differences between inactivated and attenuated vaccines and the different degrees of immunosuppression and correlates them with the administration of both mandatory and optional vaccines recommended to our patients with IBD. Finally, as a summary, 17 recommendations are established based on the available scientific evidence and expert opinion. A multidisciplinary team with extensive experience in IBD and vaccination, made up of specialists in gastroenterology, paediatrics, nursing and pharmacy, has participated in the preparation of these recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis.


Subject(s)
Colitis, Ulcerative , Crohn Disease , Inflammatory Bowel Diseases , Pregnancy , Female , Humans , Child , Colitis, Ulcerative/drug therapy , Crohn Disease/drug therapy , Inflammatory Bowel Diseases/drug therapy , Immunosuppressive Agents/adverse effects , Vaccination , Chronic Disease
2.
J Pediatr Gastroenterol Nutr ; 70(6): 727-733, 2020 06.
Article in English | MEDLINE | ID: covidwho-1722710

ABSTRACT

INTRODUCTION: With the current coronavirus disease 2019 (COVID-19) pandemic, concerns have been raised about the risk to children with inflammatory bowel diseases (IBD). We aimed to collate global experience and provide provisional guidance for managing paediatric IBD (PIBD) in the era of COVID-19. METHODS: An electronic reporting system of children with IBD infected with SARS-CoV-2 has been circulated among 102 PIBD centres affiliated with the Porto and Interest-group of ESPGHAN. A survey has been completed by major PIBD centres in China and South-Korea to explore management during the pandemic. A third survey collected current practice of PIBD treatment. Finally, guidance points for practice have been formulated and voted upon by 37 PIBD authors and Porto group members. RESULTS: Eight PIBD children had COVID-19 globally, all with mild infection without needing hospitalization despite treatment with immunomodulators and/or biologics. No cases have been reported in China and South Korea but biologic treatment has been delayed in 79 children, of whom 17 (22%) had exacerbation of their IBD. Among the Porto group members, face-to-face appointments were often replaced by remote consultations but almost all did not change current IBD treatment. Ten guidance points for clinicians caring for PIBD patients in epidemic areas have been endorsed with consensus rate of 92% to 100%. CONCLUSIONS: Preliminary data for PIBD patients during COVID-19 outbreak are reassuring. Standard IBD treatments including biologics should continue at present through the pandemic, especially in children who generally have more severe IBD course on one hand, and milder SARS-CoV-2 infection on the other.


Subject(s)
Coronavirus Infections/therapy , Inflammatory Bowel Diseases/therapy , Pneumonia, Viral/therapy , Adolescent , Adult , Betacoronavirus , COVID-19 , Child , Consensus , Coronavirus Infections/chemically induced , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Health Care Surveys , Humans , Immunologic Factors/adverse effects , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/epidemiology , Pandemics , Pneumonia, Viral/chemically induced , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Severity of Illness Index
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